Climate Process Team on Internal Wave-Driven Ocean Mixing.

Diapycnal mixing plays a primary role in the thermodynamic balance of the ocean and, consequently, in oceanic heat and carbon uptake and storage. Though observed mixing rates are on average consistent with values required by inverse models, recent attention has focused on the dramatic spatial variability, spanning several orders of magnitude, of mixing rates in both the upper and deep ocean. Away from ocean boundaries, the spatio-temporal patterns of mixing are largely driven by the geography of generation, propagation and dissipation of internal waves, which supply much of the power for turbulent mixing.

Development and validation of the irritable bowel syndrome satisfaction with care scale.

Background & Aims: Satisfaction with care is an important measure of quality, from the patients' perspective, and could also affect outcomes. However, there is no standard measure of patient satisfaction for irritable bowel syndrome (IBS) care; a multi-item, condition-specific instrument is needed.

Methods: Using standard qualitative methods, we conducted focus groups to identify items that patients associated with satisfaction in their care for IBS.

International survey of patients with IBS: symptom features and their severity, health status, treatments, and risk taking to achieve clinical benefit.

Background: Although clinicians generally make treatment decisions in irritable bowel syndrome (IBS) related to the type of symptoms, other factors such as the perceived severity and the risks patients are willing to tolerate for effective treatment are also important to consider. These factors are not fully understood.

Objective: To describe among patients with IBS their symptoms and severity, quality of life and health status, medications taken, and the risk that they would take to continue medications for optimal relief.

A focus group assessment of patient perspectives on irritable bowel syndrome and illness severity.

There is a growing need to understand from the patient's perspective the experience of irritable bowel syndrome (IBS) and the factors contributing to its severity; this has been endorsed by the Food and Drug Administration (FDA). Accordingly, we conducted focus groups to address this issue. A total of 32 patients with mostly moderate to severe IBS were recruited through advertising and were allocated into three focus groups based on predominant stool pattern.

Gender, age, society, culture, and the patient's perspective in the functional gastrointestinal disorders.

Patients with functional gastrointestinal disorders (FGID) often experience emotional distress, a perceived lack of validation, and an unsatisfactory experience with health care providers. A health care provider can provide the patient with a framework in which to understand and legitimize their symptoms, remove self-doubt or blame, and identify factors that contribute to symptoms that the patient can influence or control. This framework can be strengthened with the consideration of various important factors that impact FGID but are often overlooked.

Priorities for treatment research from different professional perspectives.

The consensus conference "Advancing the Treatment of Fecal and Urinary Incontinence Through Research" had as one of its goals the development of a comprehensive list of research priorities. Experts from all disciplines that treat incontinence-gastroenterology, pediatric gastroenterology, urology, urogynecology, colorectal surgery, geriatrics, neurology, nursing, and psychology-and patient advocates were asked to identify their highest priorities for treatment-related research. Meeting participants were shown the aggregated list and invited to propose additional priorities.

The perspective of the patient.

The International Foundation for Functional Gastrointestinal Disorders (IFFGD) is a nonprofit education and research group. Founded in 1991, the IFFGD provides information and advice to patients around the world with fecal incontinence and other gastrointestinal disorders, educates physicians through medical symposia and other activities, funds and undertakes research, and provides testimony to Congress about the necessity of furthering research activities related to fecal incontinence through the National Institutes of Health. The IFFGD advocates research directed toward more comprehensive identification of quality-of-life issues associated with fecal incontinence and improved assessment and communication of treatment outcomes related to quality of life, standardization of scales to measure incontinence severity and quality of life, assessment of the utility of diagnostic tests for affecting management strategies and treatment outcomes, development of new drug compounds offering new treatment approaches to fecal incontinence, development and testing of strategies for primary prevention of fecal incontinence associated with childbirth, and further understanding of the process of stigmatization as it applies to the experience of individuals with fecal incontinence.